Organization
SOULSTICE SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYSE GEHRET (FOUNDER)
(415) 847-1644
Entity
Organization
Contact information
Practice address
2462 W 3RD ST, SANTA ROSA, CA 95401-6425
(707) 843-3539
Mailing address
512A JOHNSON ST, SAUSALITO, CA 94965-2123
(415) 847-1644
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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